Spark Dental LLC
NPI #1760221386 in Hagerstown, Maryland
Provider Information
- NPI Number
- 1760221386
- Entity Type
- Organization
- Organization Name
- Spark Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 22, 2024
- Last Updated
- May 22, 2024
Practice Location
- Address
- 18077 GARLAND GROH BLVD
- City
- Hagerstown
- State
- Maryland
- ZIP Code
- 21740-2064
- Phone
- (301) 888-8555
Authorized Official
- Name
- DR. MADHU VENKATA RAMA RAJU NADIMPALLI, DDS,MPA
- Title
- GENERAL DENTIST/ OWNER
- Phone
- (201) 257-7095
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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